Tuesday, April 15, 2008

[JAMA's] editor, Catherine D. DeAngelis, said her journal had been duped by a ghostwritten manuscript in 2002 that compared Vioxx with two competitors' drugs for knee pain, and she acknowledged that editors bore some responsibility.

There is a New Jersey connection to the ghostwriting:

JAMA authors found documents indicating that Merck employees had written papers or hired ghostwriting firms to do so.

DeAngelis, in an interview, lambasted medical ghostwriters, calling their work "a terrible form of prostitution" and said it was another sign of how physicians and researchers had succumbed to drug firms' influence.

"We've given up the profession," DeAngelis said, "and we've got to get it back."

The first draft of a 2002 Vioxx article published in JAMA was written by staff of Scientific Therapeutics in Springfield, N.J., according to the JAMA article.

In the law area, in the matter of the Laurence Tribe plagiarism incident, there is speculation that the plagiarism may have actually been the work of a ghostwriter. Of course, Tribe's name was on the work. What to do when ghostwriters plagiarize, or write things that aren't strictly true?

Of the JAMA paper reporting ABOUT the ghost writing matter -->

Lead author of the JAMA article [asserting the ghostwriting], Joseph S. Ross, a geriatrician at Mt. Sinai School of Medicine in New York, said ghostwriting had been used for other drugs, including the anticonvulsive drug Neurontin.

"Our suspicion is that it's quite common," said Ross, who has consulted for Vioxx plaintiffs' attorneys. "It taints all the potential legitimate research that is being done by the pharmaceutical industry."

Ross and his colleagues cited an Alzheimer's study that initially listed Merck scientists as authors and came to show three outside researchers in the top spots.

The New York Times noted: Merck on April 15 acknowledged that is sometimes hires outside medical writers to draft research reports before handing them over to the doctors whose names eventually appear on the publication.

The Times mentioned a JAMA editorial: “It is clear that at least some of the authors played little direct roles in the study of review, yet still allowed themselves to be named as authors,” the editorial said.

The Washington Post raised the issue of credibility: Simultaneously, Merck was using what the JAMA authors call "guest authorship and ghostwriting" to make it appear that research done by its employees or contractors was the work of scientists at medical schools and universities. That presumably gave the findings more credibility when they were published, in medical journals, boosting Vioxx's profile in the crowded painkiller market. Sort of like Mark Lemley of Stanford writing a law review article in the Texas law review favorable to the IT/Cisco viewpoint on damages AND for which the research for the article was paid for by Cisco and Microsoft and other IT folks.

What kind of fraud could possibly involve academic researchers and universities? The answer is the ghostwriting of research articles that appear in reputable medical journals. Let’s be very clear about our definition of ghostwriting. It’s not about substantial editorial assistance for researchers for whom English is not their first language. It’s not about articles that have multiple authors, some of whom worked on only small parts of the research project. It’s also not about honorary authorship, although it is related. Ghostwritten, as defined here, is when an article is written by one person, often someone working directly or indirectly for a pharmaceutical company, and a second person, often a well-known academic researcher, is paid for letting his or her name appear on the by-line, concealing the article’s origin. According to recent studies in JAMA and the British Journal of Psychiatry, somewhere between 11% and 50% of articles on pharmaceuticals that appear in the major medical journals are thought to be ghostwritten.

The people who sell their name are lowly, third-rate researchers, right? Unfortunately, no. They are some of the best and brightest because the pharmaceutical companies want the support of “key opinion leaders.” “Support,” you ask? Surely the articles reflect impartial analyses. Unfortunately, again, this is not an accurate assumption. According to a study in JAMA, the industry sponsored articles report more favorably on a drug than those done by independent researchers by an 8:1 margin. And the ghostwritten articles appear in more prestigious journals and are cited more often by other researchers.

IPBiz notes that the last line is also quite relevant to PageRank, as used by Google.

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